Open AccessEndoscopic ultrasonography-guided biliary drainage: Who, when, which, and how?
Author(s) -
Kazuo Hara,
Kenji Yamao,
Nobumasa Mizuno,
Susumu Hijioka,
Hiroshi Imaoka,
Masahiro Tajika,
T Tanaka,
Makoto Ishihara,
Nozomi Okuno,
Nobuhiro Hieda,
Tukasa Yoshida,
Yasumasa Niwa
Publication year - 2016
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v22.i3.1297
Subject(s) - medicine , biliary drainage , endoscopic ultrasonography , endoscopic retrograde cholangiopancreatography , radiology , endoscopic ultrasound , biliary tract , endoscopy , percutaneous , surgery , pancreatitis
Both endoscopic ultrasonography (EUS)-guided choledochoduodenostomy (EUS-CDS) and EUS-guided hepaticogastrostomy (EUS-HGS) are relatively well established as alternatives to percutaneous transhepatic biliary drainage (PTBD). Both EUS-CDS and EUS-HGS have high technical and clinical success rates (more than 90%) in high-volume centers. Complications for both procedures remain high at 10%-30%. Procedures performed by endoscopists who have done fewer than 20 cases sometimes result in severe or fatal complications. When learning EUS-guided biliary drainage (EUS-BD), we recommend a mentor's supervision during at least the first 20 cases. For inoperable malignant lower biliary obstruction, a skillful endoscopist should perform EUS-BD before EUS-guided rendezvous technique (EUS-RV) and PTBD. We should be select EUS-BD for patients having altered anatomy from malignant tumors before balloon-enteroscope-assisted endoscopic retrograde cholangiopancreatography, EUS-RV, and PTBD. If both EUS-CDS and EUS-HGS are available, we should select EUS-CDS, according to published data. EUS-BD will potentially become a first-line biliary drainage procedure in the near future.